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Cited by 133Fatty Acid Research and HealthCoronary Interventions and DiagnosticsLipoproteins and Cardiovascular Health

Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

Nishio, Ryo, Shinke, Toshiro, Otake, Hiromasa, Nakagawa, Masayuki, Nagoshi, Ryoji, Inoue, Takumi, Kozuki, Amane, Hariki, Hirotoshi +8 more·2014·Atherosclerosis
DOI 10.1016/j.atherosclerosis.2014.02.025
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Abstract

Background The addition of highly purified eicosapentaenoic acid (EPA) to statin therapy prevents cardiovascular events. However, the impact of this treatment on vulnerable plaques remains unclear. The aim of this study was to assess the impact of adding EPA to a standard statin therapy on vulnerable plaques by serial optical coherence tomography (OCT).Methods Forty-nine non-culprit thin-cap fibroatheroma (TCFA) lesions in 30 patients with untreated dyslipidemia were included. Patients were randomly assigned to EPA (1800 mg/day) + statin (23 TCFA, 15 patients) or statin only (26 TCFA, 15 patients) treatment. The statin (rosuvastatin) dose was adjusted to achieve a target low-density lipoprotein (LDL) level of <70 mg/dL. Post-percutaneous intervention and 9-month follow-up OCT were performed to evaluate morphological changes of TCFAs. The EPA/arachidonic acid (EPA/AA) ratio and pentraxin-3 (PTX3) levels were also evaluated.Results Despite similar follow-up LDL levels, the EPA + statin group had higher EPA/AA ratios and lower PTX3 levels than the statin group. OCT analysis showed that the EPA + statin group had a greater increase in fibrous-cap thickness, with a greater decrease in lipid arc and lipid length. Macrophage accumulation was less frequently detected in the EPA + statin group than in the statin group at follow-up. When the patients were categorized according to their follow-up PTX3 tertiles, fibrous-cap thickness showed significant increase, and the incidence of macrophages accumulation decreased with lower PTX3 levels.Conclusion The concomitant use of EPA and rosuvastatin may stabilize vulnerable plaques better than the statin alone, possibly by suppressing arterial inflammation.

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  • Some clinical studies with higher-dose EPA suggest beneficial effects on markers of oxidation and inflammation, coronary plaque characteristics, and major CV events.

    “In addition to beneficial changes to TG‐rich lipoproteins and other plasma lipid markers, some clinical studies with higher‐dose EPA also suggest beneficial effects on markers of oxidation and inflammation, coronary plaque characteristics, and major CV events.16, 25, 26, 29, 31, 32, 33”

    From Rationale and design of <scp>REDUCE‐IT</scp> : Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (2017) · cites this paper as [32]

  • Studies administering higher-dose EPA suggest additional beneficial effects beyond lipid-lowering that may be unique to EPA relative to other TG-lowering therapies, such as beneficial changes in coronary plaque characteristics, which may lead to reductions in major CV events.

    “Finally, studies administering higher‐dose EPA suggest additional beneficial effects beyond lipid‐lowering that may be unique to EPA relative to other TG‐lowering therapies, such as beneficial changes in coronary plaque characteristics, which may lead to reductions in major CV events.4, 16, 25, 26, 27, 28, 29, 30, 31, 32, 33”

    From Rationale and design of <scp>REDUCE‐IT</scp> : Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (2017) · cites this paper as [32]

  • EPA has unique lipid and lipoprotein, antiinflammatory, antiplatelet, antithrombotic, and cellular modifying effects, all of which may contribute to benefits in atherosclerotic processes such as reduced development, slowed progression, and increased stabilization of atherosclerotic plaque.

    “EPA has unique lipid and lipoprotein, antiinflammatory, antiplatelet, antithrombotic, and cellular modifying effects, all of which may contribute to benefits in atherosclerotic processes such as reduced development, slowed progression, and increased stabilization of atherosclerotic plaque (19,(54)(55)(56).”

    From Effects of Icosapent Ethyl on Total Ischemic Events (2019) · cites this paper as [55]

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Authors
Nishio, R., Shinke, T., Otake, H., Nakagawa, M., Nagoshi, R., Inoue, T., Kozuki, A., Hariki, H., Osue, T., Taniguchi, Y., Iwasaki, M., Hiranuma, N., Konishi, A., Kinutani, H., Shite, J., & Hirata, K.-I.
Affiliations
Kobe University (JP)
ORCID
Venue
Atherosclerosis
Publisher
Elsevier BV
Published
2014-05
Volume
234
Issue
1
Pages
114-119
ISSN
0021-9150 (ISSN-L)
DOI
10.1016/j.atherosclerosis.2014.02.025
OpenAlex
W2048776656
Cited by
133
References
29
Citations by year
2026: 2 · 2025: 10 · 2024: 9 · 2023: 16 · 2022: 20 · 2021: 14 · 2020: 14 · 2019: 13 · 2018: 3 · 2017: 9 · 2016: 11 · 2015: 10 · 2014: 2
FWCI
9.94
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Atherosclerosis (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords
eicosapentaenoic acid, statin therapy, rosuvastatin, thin-cap fibroatheroma, coronary artery disease, pentraxin 3, fibrous cap thickness, lipid arc, macrophage accumulation, arterial inflammation, dyslipidemia, percutaneous coronary intervention
MeSH terms
Coronary Artery Disease, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Eicosapentaenoic Acid, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Tomography, Optical Coherence, Plaque, Atherosclerotic

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